New Orleans is next coronavirus epicenter, catalyst for spread in south, experts say

By Brad Brooks

(Reuters) – New Orleans is on track to become the next coronavirus epicenter in the United States, dashing hopes that less densely populated and warmer-climate cities would not be hit as hard by the pandemic, and that summer months could see it wane.

The plight of New Orleans – with the world’s highest growth rate in coronavirus cases and where authorities have warned hospitals could collapse by April 4 – also raises fears it may be a powerful catalyst in speedily spreading the virus across the south of the country.

New Orleans is the biggest city in Louisiana, the state with the third-highest case load of coronavirus in the United States on a per capita basis after the major epicenters of New York and Washington. The growth rate in Louisiana tops all others, according to a University of Louisiana at Lafayette analysis of global data, with the number of cases rising by 30% in the 24 hours before noon on Wednesday. On Tuesday, U.S. President Donald Trump issued a major federal disaster declaration for the state, freeing federal funds and resources.

Some 70% of Louisiana’s 1,795 confirmed cases to date are in the New Orleans metro area.

The culprit for the coronavirus in the Big Easy? Some blame Carnival.

“Mardi Gras was the perfect storm, it provided the perfect conditions for the spread of this virus,” said Dr. Rebekah Gee, who until January was the Health Secretary for Louisiana and now heads up Louisiana State University’s health care services division.

She noted that Fat Tuesday fell on Feb. 25 – when the virus was already in the United States but before the Centers for Disease Control and Prevention and national leaders had raised the alarm with the American public.

“So New Orleans had its normal level of celebration, which involved people congregating in large crowds and some 1.4 million tourists,” Gee said. “We shared drink cups. We shared each other’s space in the crowds. We shared floats where we were throwing not just beads but probably coronavirus off Carnival floats to people who caught it and took it with them to where they came from.”

Gee said that the explosive growth rate of the coronavirus in the Mississippi River port city means “it’s on the trajectory to become the epicenter for the outbreak in the United States.”

RESILIENT, BUT WARY

Dr. Peter Hotez is the dean of the National School of Tropical Medicine at Baylor College, a renowned vaccine scientist and an expert on the coronavirus pandemic.

He said that the rapid grip the virus is gaining on New Orleans was deeply worrying and a possible harbinger for worse to come across the south and for less densely populated and warmer cities across America.

“There has been some research and data suggesting that warmer, more humid weather could slow this epidemic,” he said. “The fact that this occurred on the Gulf Coast, which has some of the higher humidity and temperatures in the U.S., is a serious concern.”

Hotez noted that more research into how climate does or does not play a role in the spread of this coronavirus needs to happen, but acknowledged that experts hoped that warm weather and the coming summer months in the northern hemisphere would be natural buffers against it.

“If you look at this epidemic, we’ve not seen much in the hotter parts of the country. Texas has not had a lot. Arizona has not had a lot. Then all of a sudden – bam! – it appears in strength in New Orleans,” he said. “We have to follow this trend closely.”

Having an entirely new coronavirus epicenter kick off means that the United States may soon be dealing with multiple hot spots all at once, Hotez said – a worst-case scenario that could cripple healthcare systems.

If predictions were correct, the hospitals in New Orleans would struggle to manage past next week, Governor John Bel Edwards told a news conference on Tuesday.

New Orleans could well be the first major domino to fall in the south, starting a chain reaction in other metro areas in the region, said Hotez.

That is a serious concern for Houston, the fourth-largest city in the country and a major center for the oil industry. The two cities have historically strong links made even more so by an influx of New Orleans residents into Houston following Hurricanes Katrina and Harvey.

On the ground in New Orleans’ famed French Quarter, residents said they were definitely concerned, but that the virus was an entirely different threat from the natural disasters that routinely befall the city.

Jonathan Sanders, a 35-year-old general manager of the French Quarter brasserie Justine, said the city was calm and residents largely heeding authorities orders to stay inside.

“There is always something going on at all hours of the day or night. Now, without it all, it’s very peaceful,” he said. “You can park anywhere in the French Quarter.”

The virus, Sanders said, was so far easier to deal with than the death and destruction Hurricane Katrina unleashed in 2005, when over 1,800 people died along the Gulf Coast.

“When you think of the total destruction of Katrina… that was gut wrenching,” he said. “We’re fairly more resilient than other places that haven’t had so many tragic things happen to their city.”

U.S. officials to urge ‘aggressive’ local steps against coronavirus

Reuters
By Susan Heavey

WASHINGTON (Reuters) – The Trump administration on Wednesday plans to urge U.S. states and localities to take stronger steps to fight the coronavirus, Health Secretary Alex Azar said, as the governor of at least one state criticized the federal government’s handling of the outbreak.

“You’re going to hear from CDC today and the White House that we’re going to be making recommendations to those local communities about aggressive steps that we think they should be taking,” Azar told Fox News in an interview.

He did not detail what the recommendations would be. U.S. Vice President Mike Pence had told reporters on Tuesday that recommendations by the Centers for Disease Control and Prevention would be aimed at communities that have already seen spread of the disease.

Azar said federal leaders were working with local officials in the hardest hit states so far, including Washington, California, New York, Massachusetts, and Florida, saying “strong mitigation steps” could help buy valuable time.

The governor of New York, however, said federal officials had left states scrambling to act on their own, including ramping up testing for the highly contagious – and sometimes fatal – respiratory illness.

“We can’t wait for the federal government because it’s not going to happen,” said Andrew Cuomo, who has deployed the National Guard to help contain an outbreak in the suburbs of New York City.

“The federal government has just fallen down on the job,” Cuomo, a Democrat, told MSNBC in an interview, adding that he had told other state governors, “you’re on you own.”

The number of U.S. coronavirus cases has risen steadily and has affected almost three-quarters of the states. More than 1,025 cases and 28 deaths have been reported, according to a count by Johns Hopkins University.

State and local officials have said a delayed U.S. response over testing capabilities has hampered their ability to manage the outbreak, even as U.S. President Donald Trump has offered assurances that anyone who wanted a test could get one.

Police wearing riot gear broke up a protest by hundreds of students at the University of Dayton in Ohio after the school announced the temporary suspension of classes and on-campus housing on Tuesday, the Dayton Daily News reported.

Washington Governor Jay Inslee is expected on Wednesday to restrict large gatherings in three counties at the center of the coronavirus outbreak in the state, according to the Seattle Times. The move will be aimed at sports, concerts and other cultural events and will not affect retail stores, the newspaper reported.

Pence, tasked by Trump to lead the nation’s coronavirus response, met with a number of U.S. governors at the White House on Monday.

Maryland’s governor, Republican Larry Hogan, afterward praised Pence but criticized the mixed message coming from Trump, telling the Washington Post after the meeting that the Republican president “at times just says whatever comes to mind or tweets.”

New York’s Cuomo said his state was moving aggressively on its own to expand testing, including the implementation of mobile testing seen in other countries.

“It’s either massive testing or massive quarantine, and we don’t want to quarantine, so we’re going to have to do the testing,” he told MSNBC.

(Reporting by Susan Heavey in Washington and Maria Caspani in New York; Writing by Alistair Bell; Editing by Steve Orlofsky and Rosalba O’Brien)

Measles outbreak spreads to Oklahoma as U.S. reports 41 new cases

FILE PHOTO: FILE PHOTO: FILE PHOTO: A vial of the measles, mumps, and rubella virus (MMR) vaccine is pictured at the International Community Health Services clinic in Seattle, Washington, U.S., March 20, 2019. REUTERS/Lindsey Wasson/File Photo/File Photo/File Photo

(Reuters) – The worst measles outbreak in the United States in 25 years has spread to Oklahoma, federal health officials said on Monday as they reported 41 new cases nationwide, raising the total number sickened this year to 880 people.

The U.S. Centers for Disease Control and Prevention reported a 4.9% increase in the number of measles cases from May 10 to May 17 in an outbreak that has now reached 24 states. The agency has been providing weekly updates every Monday.

The CDC said there had been one confirmed case in Oklahoma.

Most of the new cases were in New York, CDC spokesman Jason McDonald said, with 21 cases recorded in New York City and nine in Rockland County.

Health experts say the virus has spread among school-age children whose parents declined to give them the vaccine, which confers immunity to the disease. A vocal fringe of U.S. parents, some in New York’s ultra-Orthodox Jewish communities, cite concerns that the vaccine may cause autism, despite scientific studies that have debunked such claims.

Although the virus was eliminated from the country in 2000, meaning the disease was no longer a constant presence, outbreaks still happen via travelers coming from countries where measles is still common, according to the CDC.

Experts warn that the outbreak is not over as the number of cases approaches the 1994 total of 958. That was the highest number since 1992, when the CDC recorded 2,126 cases.

More than 40 people in 2019 brought measles to the United States from other countries, most frequently Ukraine, Israel and the Philippines, federal officials said.

(Reporting by Gabriella Borter in New York, Ankur Banerjee in Bengaluru; Editing by Scott Malone and Bill Berkrot)

Up to 84,000 Americans hospitalized with flu in past three months – CDC

FILE PHOTO: A triage surge tent is seen outside Loma Linda University Health Center for patients infected with an influenza A strain known as H3N2, in Loma Linda, California U.S. January 17, 2018. REUTERS/Lucy Nicholson

An estimated 69,000 to 84,000 Americans were hospitalized due to the flu in the last three months, the Centers for Disease Control and Prevention (CDC) said on Friday.

The nation saw one of the worst flu outbreaks in nearly a decade during the 2017-2018 season, with more than 900,000 cases of hospitalizations and over 80,000 deaths, the CDC estimates https://www.cdc.gov/flu/spotlights/press-conference-2018-19.htm#ref1.

Between Oct. 1, 2018 and Jan. 5, 2019, about 6 million to 7 million people were reported to have contracted the flu, according to data collected by the health agency.

Health regulators have been trying to combat flu outbreaks in the United States and the U.S. Food and Drug Administration approved the first new flu medication in nearly two decades last year.

The CDC last month (click here https://www.cdc.gov/flu/spotlights/flu-activity-elevated.htm) signaled the start of the flu season, saying that 24 states and Guam were reporting widespread cases, with the H1N1 virus being the predominant strain.

The dominant flu strain during the last season, H3N2, has been linked with severe disease and death, particularly among children and the elderly.

The agency continues to recommend vaccination as the best way to reduce the risk of flu and advised people who are at high-risk category to approach hospital for treatment with a flu antiviral drug.

(Reporting by Saumya Sibi Joseph in Bengaluru; Editing by James Emmanuel)

Tick, mosquito-borne infections spiking in United States: CDC

FILE PHOTO - A sign is displayed as San Diego County officials hand spray a two block area to help prevent the mosquito-borne transmission of the Zika virus in San Diego, California, U.S. August 19, 2016. REUTERS/Earnie Grafton

By Gina Cherelus

NEW YORK (Reuters) – The number of Americans sickened each year by bites from infected mosquitoes, ticks or fleas tripled from 2004 through 2016, with infection rates spiking sharply in 2016 as a result of a Zika outbreak, U.S. health officials said on Tuesday.

The U.S. Centers for Disease Control and Prevention said that some 96,075 diseases caused by bites by mosquitoes, ticks and fleas were reported in 2016, up from 27,388 in 2004, in an analysis of data from the CDC’s National Notifiable Diseases Surveillance System.

Infections in 2016 went up 73 percent from 2015, reflecting the emergence of Zika, which is transmitted by mosquitoes and can cause severe birth defects. Zika was the most common disease borne by ticks, mosquitoes and fleas reported in 2016, with 41,680 cases reported, followed by Lyme disease, with 36,429 cases, almost double the number in 2004.

The increases may be a result of climate change, with increased temperatures and shorter winters boosting populations of ticks, mosquitoes and other disease-carrying creatures known as “vectors.”

“It enables these ticks to expand to new areas. Where there are ticks, there comes diseases,” said Lyle Petersen, director of the CDC’s Division of Vector-Borne Diseases.

Warmer summer temperatures also tend to bring outbreaks of mosquito-borne illnesses, Petersen said.

While Zika stood out as the latest emerging threat in the report, it also showed a long-term increase in cases of tick-borne Lyme disease, which can attack the heart and nervous system if left untreated.

Researchers warned that their numbers likely do not include every case as many infections are not reported.

These increases are due to many factors, including growing populations of the insects that transmit them and increased exposure outside of the United States by travelers who unknowingly transport diseases back home.

The CDC said more than 80 percent of vector-control organizations across the United States lack the capacity to prevent and control these fast-spreading, demanding illnesses. Petersen said that federal programs are increasing funding for those organizations.

(Reporting by Gina Cherelus; editing by Scott Malone and Grant McCool)

U.S. flu outbreak worsens, likely to linger for weeks: CDC

A box of masks is shown in the emergency room at Palomar Medical Center in Escondido, California, U.S., January 18, 2018

(Reuters) – One of the worst flu outbreaks in the United States in nearly a decade worsened last week and will likely linger for several weeks, causing more deaths, the Centers for Disease Control and Prevention said on Friday.

Another 10 children were reported to have died of the flu in the week ending Feb. 3, bringing the total infant mortality so far this season to 63, Dr. Anne Schuchat, the CDC’s acting director, told reporters. The CDC does not require national reporting of flu deaths in adults.

“I wish there were better news this week, but almost everything we’re looking at is bad news,” Schuchat said. “There have been far too many heart-wrenching stories in recent weeks about families who have lost loved ones to influenza.”

It was unclear whether the outbreak had reached its peak yet or if it would get worse, she said. Previous outbreaks had lasted between 11 and 20 weeks, and the current outbreak was in its 11th week, she said.

The number of people hospitalized for flu-like illnesses is the highest the CDC has seen since starting its current tracking system in 2010.

The dominant flu strain this season, influenza A (H3N2), is especially potent, linked with severe disease and death, particularly among children and the elderly.

The outbreak has reached almost every corner of the country, with every state except Hawaii and Oregon reporting widespread flu, Schuchat said.

She urged sick people to stay home and said it is still not too late for people to get a flu vaccine, which offers some protection.

(Reporting by Jonathan Allen in New York; Editing by Paul Simao)

CDC director urges flu vaccinations as pediatric deaths mount

Emergency room nurse Christine Bauer treats Joshua Lagade of Vista, California, for the flu as his girlfriend Mayra Mora looks on in the emergency room at Palomar Medical Center in Escondido, California, U.S., January 18, 2018.

By Julie Steenhuysen

CHICAGO (Reuters) – Of the 30 U.S. children who have died from the flu so far this season, some 85 percent had not been vaccinated, said Centers for Disease Control and Prevention Director Dr. Brenda Fitzgerald, who urged Americans to get flu shots amid one of the most severe flu seasons in years.

“My message is, if you haven’t gotten a vaccine, please get a vaccine. Also, please get your children vaccinated,” said Fitzgerald, who is urging citizens “to take every advantage that you can to protect yourself.”

The dominant strain during this flu season is an especially nasty type called influenza A (H3N2) that in seasons past has been linked with severe disease and death, especially in the elderly and young. This year’s seasonal flu epidemic is especially severe.

In its latest report, the CDC said the virus is present in every state, with 32 states reporting severe flu activity.

Although the vaccine is only estimated to be about 30 percent effective against the H3N2 strain, it has been shown in studies to reduce severity and duration if people do become infected, said Dr. Dan Jernigan, director of the influenza division at the Centers for Disease Control and Prevention.

Fitzgerald conceded in a telephone interview that reports that the flu vaccine in Australia was only 10 percent effective may have caused people to think the vaccine would not be worth the trouble.

Fitzgerald said the agency’s flu division has been on the job during the three-day federal government shutdown. Senators on Monday reached a deal to keep the government funded through Feb. 8.

Studies have shown that even a vaccine that has lower overall effectiveness can decrease the number of days spent in hospital, duration of the flu and the degree of symptoms.

“That helps support the point of getting a vaccine,” Jernigan said.

Fitzgerald said the flu vaccine and antiviral drugs used to fight the flu are widely available across the country, noting that people can go to the CDC website and enter their zip code to find the nearest flu clinics with vaccines.

Fitzgerald also recommended that people frequently wash their hands or use hand sanitizer, avoid those who are sick or coughing and carry disinfectant wipes.

The CDC does not have numbers for adult deaths from the flu because adult flu is not a reportable disease in all U.S. states. But she said North Carolina, which collects such data, has reported 42 adult flu deaths so far this season.

Official estimates from the CDC are expected at the end of the current season, based on a calculation from hospitals and states reporting data to the agency.

In the 2014/2015 flu season, in which the H3N2 strain was also the leading strain, there were an estimated 35.6 million cases, 710,000 hospitalizations and 56,000 deaths. At this point, it is not clear whether the current flu season will surpass those estimates, Jernigan said.

(Reporting by Julie Steenhuysen; Editing by Cynthia Osterman)

Plague in Madagascar Surprises and Alarms World Health organizations, U.S. not immune

World Health Organization responding to Seychelles plague

By Kami Klein

Experts are alarmed at a recent outbreak of plague that is spreading through major populated areas in Madagascar.  So far there has been 1,836 suspected or confirmed cases of pneumonic plague and 133 deaths in areas that have never seen this form of the disease before.

Every year Africa and Madagascar deal with an outbreak of plague within their borders. The World Health Organization (WHO) anticipates this in outlying areas and is ready to step in with antibiotics and information which eventually curtails the outbreak.  This year, health organizations around the world were surprised as the plague has spread so quickly and is primarily being found in heavily populated areas. While they anticipate around 400 cases a year, this year’s outbreak began sooner and a different strain of the disease has the world watching.

What is causing the alarm is that 65% of the plague occurring in Madagascar, pneumonic plague, is the only form that can be spread from human to human through droplets from coughing.  This makes containing the disease much more difficult and the chances that there will be more deaths almost certain.

According to the Center for Disease Control here in the United States, there are major differences in bubonic plague and pneumonic. Bubonic plague is spread to humans by the bites of infected fleas that live on small mammals such as rats.Without treatment, it kills up to two-thirds of those infected. One in 10 cases will develop into pneumonic plague which is almost always fatal if not treated quickly with antibiotics. This form, can and will spread from human to human which is the case in this outbreak. The good news is that a simple short course of antibiotics can cure the plague, providing it is given early.

Dr. Tim Jagatic told BBC News that the outbreak had spread to populated areas when a man infected with bubonic plague had traveled from the highlands to the capital and then on to the coastal city of Tamatave by bus.

“He had the bubonic form of the plague and entered into one of the major cities, where the bubonic version of the disease had the potential of turning into the pneumonic form without treatment.”

“He was in a closed environment with many people when he started to develop severe symptoms, and he started to transmit the pneumonic form of the disease to others.”

“So it wasn’t recognised until later,” he said, allowing the disease to “proliferate over a period of time unabated”.

This  case infected 31 other people, according to the WHO, four of whom died. It wasn’t until a couple of weeks later that an outbreak of the plague was detected and officially confirmed.

Although a travel ban has not been issued as of yet, officials do expect another spike in the disease before the season ends in April.  Medical personnel are all on  alert in parts of Africa that are most frequented by Madagascar citizens. WHO has delivered nearly 1.2 million doses of antibiotics and released $1.5 million dollars in emergency funds to fight the plague in Madagascar.

Though not widely publicized, the United States does have several cases of plague per year mostly in the Southwest. Dr Tim Jagatic, a doctor with Doctors without Borders currently working in Madagascar stated that the conditions which cause the plague outbreaks on the African island are also found in the US.

“Something today that very few people are aware of is that in the United States for instance, in the south-west, there’s an average of 11 cases of bubonic plague per year.

“These outbreaks occur simply because this is a bacteria which is able to maintain a reservoir in wild animals and every once in awhile, when humans come into contact with fleas that have had contact with the wild animals, it is able to transmit to humans.”

Information Sheet on the Plague

Information Sheet on the Plague

 

Sources:   BBC, WHO,CDC, New York Post  CNN